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General NPI Number Information
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NPI Number | 1538155353
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Entity Type | Organization
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Legal Business Name | JEANNE DIXON COUNSELING SERVICES
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 1712 DUNLAP AVE
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City | MARINETTE
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State | WI
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Zip | 54143-1709
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Country | US
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Telephone | 715-735-0227
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Fax | 715-735-7394
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Provider Business Mailing Address
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Address Line | 2619 HANNAH ST.
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City | MARINETTE
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State | WI
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Zip | 54143-1504
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Country | US
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Telephone | 715-735-0227
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Fax | 715-735-7394
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JEANNE ANN DIXON
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Credential | MS, LPC, CSAC
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Telephone | 715-735-0227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2578
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License Number State | WI
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